Tolerance and the Dangers of Self Tapering

Recently I heard a few patients tell me that they have been self tapering their Methadone dose.  They had been doing this by throwing out a small amount, each day, from their carries in an attempt to decrease the amount they are taking.  I feel that this is so dangerous that I wanted to let all my patients know the risks.  It all comes down to tolerance and safety.

Tolerance to a drug is how much the drug effect changes depending on how much of the drug you are using.  For example, if you use a lot of Heroin, you get used to it, and it does not have the same effect it used to.  In other words, your tolerance to Heroin increases the more you use it.  You need more of the drug to get the same effect over time.

The same happens with Methadone.  But the difference is that in the Methadone program, you try to deal with the tolerance that you have developed with other opiates like Heroin, Oxy, Percocets, Fentanyl, etc.  We try to get your dose of Methadone to the point where you can feel normal again.  You are not trying to get high on Methadone, so you do not end up chasing the dose higher and higher.  Once you stabilize on a Methadone dose, you are set.  You should not need to increase, or decrease, the dose.

The brain likes balance.  Tolerance is a result of the brain trying to get this balance.  When someone is increasing their Oxy dose to achieve a high, they are fighting with their brain’s natural tendency towards balance.  In the Methadone program, you are trying to achieve balance, and you are working with your brain to achieve the balance you need to feel normal once again.

Speed of tolerance is different for different effects of Methadone. Tolerance to pain control changes slowly. Tolerance to getting high changes fast.   The tolerance to stopping breathing changes very fast.  This is why you don’t stop breathing if you increase your dose slowly when you start the Methadone program.  In fact, that is why I insist on dose increases only every 3-4 days.

On the way down, the same thing happens.  Your tolerance to stopping breathing lowers faster than the other tolerances.  This means that if you spend a few days at a lower dose, and then raise it again, you can stop breathing.  That is why your dose has to be lowered if you miss 3 doses, and you have to restart the program if you miss 4 or more.  It is all about safety.

Now, if you self taper yourself down, a few things can happen.  For one, you really don’t know how much you are decreasing your dose.  You may be going down too fast one day, and less on another.  Just watch your pharmacist prepare your dose carefully and see how hard it is for them to get your dose just right.  You cannot do it yourself safely.  Also, if I don’t know about it, I cannot monitor you for dangerous effects.  You will also be having withdrawals, and not telling me about them.  Again, I will not be able to help you.

When you do your supervised doses, the pharmacist will give you your regular dose, which will be higher than your tapered dose.  This is dangerous, because the tolerance to stopping breathing, and possibly dying, changes faster than the tolerance to withdrawal issues.  So that one dose can in fact be dangerous.

Here is a very dangerous situation:  Imagine that you are self tapering.  You run into a dosing wall, and feel the withdrawals every day.  You decide that you give up, and start taking your regular dose again.  Doing this CAN KILL YOU.

Here is the bottom line: DON’T SELF TAPER.  If you want to decrease your dose, tell me.  I may agree that it is time to to lower your dose.  On the other hand, I might suggest that you don’t decrease your dose, and would explain my reasons for feeling that you are not ready.   But I will never stop you from lowering your dose.  If you insist on lowering your dose, I will do it, even if I disagree.  This way, I will know what is going on in your dosing, and  I can help you stay out of trouble if things don’t work out as well as you would like.  Remember, it is all about safety.

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Many people find that boredom is a major trigger to using drugs, even if they may be at the right Methadone or Suboxone dose. You might use “only” once or twice a week. You might say that you are bored and don’t know what to do, so you use. You might find that hanging out with the wrong people causes you to use. Are you hanging out with them because you are bored and don’t know what to do?

Boredom is a good sign. I love it when patients tell me they are bored. Boredom means you are getting better. In the past, you may have spent your time waking up in withdrawal, only able to think about where you will get money for your fix. Then there is time trying to score, and then being high. Being addicted to opiates is a lot of work, and it takes up a lot of time. When you are getting better, you may find that you have a lot of extra time on your hands.

One way to deal with boredom is to explore a hobby. Maybe you used to like to do some art or play a musical instrument, but gave it up when you started using drugs. You have likely forgotten how much you like to do these things. Art and music are great for relaxing and feeling creative. If you have never tried art or music, now is a good time to try. Go into an art store or a used musical instrument store and see what is available. It is fun, and can be a life long source of enjoyment.

Exercise is a great way to fill those boring moments. It is also very good for feeling healthy. You don’t have to dive right into boxing, skiing, or cycling, but you can work up to it. Walking a block, then jogging a block, and so on, is a great way to start. Don’t push yourself too hard at first. You want to set a pattern for yourself, and so you don’t want to overdo it at first. In the winter, skating and just walking in the snow are more fun than you may think. Give it a try.

Hanging out with friends is also a great way to deal with boredom, but be selective about which friends you hang with. Hanging with user friends will only result is one thing – relapse. Maybe you had friends, that did not use drugs, that you stopped seeing when you starting using drugs. Those are the friends you should go back to. They will likely be more forgiving than you can even imagine. Family, who don’t use, can be the same. Call them up. If you feel comfortable, tell them you are clean and have very few friends who don’t use and need someone to talk to socially, just for fun. Good clean friendships are very important for a happy life.

The best way out of boredom is work. Working makes you feel better about yourself. You feel productive. You feel like you deserve, and need, a rest, so the down time is relaxing rather than boring.

If you have been out of work for a while, you may feel unprepared to go back to work. You may even feel scared to work. You may feel that a full time job will be too much to handle. A good way to ease back into work is to volunteer. That way you are free to leave if it doesn’t work out. You can also work as many or as few hours as you like. Volunteering also helps you feel good about yourself, because most cases of volunteering involves helping people. Then, when you are satisfied that you can return to work, you can take on a part time job, and gradually increase your hours to where you feel comfortable.

There are many volunteering organizations that are usually looking for people to help out. Pick something you like and believe it. Here are some suggestions, but there are many more than these:

Local Libraries

Food Bank

Salvation Army


Habitat for Humanity – They build housing for people with low income. This is construction work mainly. Many people start there, and meet people and end up with a real job in the end.

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Do You Need Photo ID?

Some patients find themselves without any form of photo identification (ID), for various reasons. Maybe you lost your wallet, got robbed, ended up in jail and never had your ID returned to you when you were released. In any case, Photo ID is essential in our society. Maybe you are managing without it right now, but eventually you will need it.

Getting an OHIP card, or renewing an old one, requires valid government issued non expired photo ID. Without this photo ID, you can’t get OHIP. That means no doctor’s visits (without paying cash), no preventive medicine visits to the family doctor, and difficulty should an emergency arise.
Please keep in mind that if you have the old ‘Red OHIP card,’ you will have to get a new one soon. In the past these cards ‘never expired,’ but due to abuse of the system, the government is slowly calling them back, and forcing you to get a new OHIP card, like everyone else. You will need ID to get a new one once they call your card back.
Photo ID is also required for various other things as well. This includes getting a driver’s license, Passport, bank account, and many other things that you need to enjoy a normal life. Part of your recovery is getting your ID straightened out.
Here are some suggestions to getting your ID:
1) Ontario Photo Card 
You can apply at any Ontario Service center.  It costs $35.  You will need a photo.  You will also need some original documents to prove your legal name, date of birth, and signature.  The requirements, and a list of acceptable documents, are available online.
2) Try getting an Age of Majority Card from the LCBO
They require some ID to get the photo ID, but then that photo ID can help you get other ID later on. For example, if you have a Birth Certificate and expired photo OHIP card, then you can get an Age of Majority card for $30. This may sound strange, but most places will not accept an expired passport or photo OHIP card as ID. But it can help you get a real photo ID by getting an Age of Majority card.
3) PAID Clinic – open weekdays
416.691.7407, 3036 Danforth Ave, Toronto On M4C1N2
4) Albion Neighbourhood services – ID clinic – open Thursday mornings
They can also help with employment and housing
416.741.1553, 1530 Albion Road ste 205
5) ID online –
6) Renegeration Outreach Community ID Clinic
156 Main st, Brampton
Free ID services
I have found the best place to go for your OHIP card is at the North East corner of Bloor and Islington.  The wait is very low if you go in the midle of the day.

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Surviving the Holidays

The Holiday seasons can be very stressful for many people. It is generally considered to be a time to get together with family and friends. You may feel that you don’t have people who want to hear from you. In all likelihood, the Holidays are probably the best time to make contact with people from your past. Generally speaking, Holidays are when people are at their most giving. It is a time to reflect on the past, and reach out to those you haven’t seen in a while. It is a time to be kind to those less fortunate than yourself.  A time to help and treat others with kindness. If you feel that you are going to be alone during the Holidays, maybe it would be a good idea to reach out, and reestablish contact with people that you care about from your past.

If you really don’t have anyone you would like to reconnect with, and feel rather lonely, then there are plenty of ways you can fill the void.  Sitting at home thinking about how miserable your life is is a recipe for disaster.  Instead, tackle the Holidays head on and get involved.  There are plenty of ways you can meet people and help others at the same time.  Food Banks, Street Missions, the United Way, the YMCA, and many more organizations are all places that really need volunteers to help during the Holidays.  Give it a try.  You will feel good about yourself, you will feel the Holiday spirit, and you will help other people feel better as well.  You may even meet a new friend.

Hopefully, the people you would like to reconnect with are non users.  The Holidays can be a time when people get together and have a few drinks or other substances.  Often, people let loose, and have a few too many, or reignite an old pattern of substance use.  In this way, the Holidays can be a dangerous time for many people.  Drinking while you are on Methadone can be lethal.  You can actually die from going to bed drunk while on methadone.  Please be careful. It would be best if you don’t drink it all. If you do, keep it to one or two drinks maximum. You will notice that the alcohol hit you harder when you’re on methadone than when you’re not. And if you find yourself having had too many, make sure you are not alone, and you stay up until you sober up. People do care about you and want to see you again.  I’m sure you know this, but the same goes for benzos.  And more than doubly so for using both benzos and alcohol together.

Hard drugs can be quite dangerous as well.  If you go back to an old drug, your tolerance will be much lower than it was when you were actively using.  Many deaths in opiate users happen when they have been clean for a while and start up again with old friends at their old dose.  It is easy to overdose when you have not used in a while.

Make the most of your Holidays. Rediscover the things and people that make you happy. And please be careful to not get back into old patterns that have given you trouble in the past.

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It has come to my attention that many patients in this clinic are using Fentanyl.  I am not entirely sure why this is a recent trend. Perhaps it is availability, or perhaps it is because it is harder to detect than other opiates.  There are a few things you need to know about Fentanyl in order to make an informed decision about whether or not to use it.

Fentanyl is a ‘transdermal’ opiate, meaning that it is taken by placing a patch on the skin, and the opiate is absorbed through the skin.  It was designed to provide a constant flow of opiate to cancer patients who are in significant pain.  Fentanyl is very potent, that is why the doses are in micrograms, not milligrams.  Some estimate that Fentanyl is 1000 times more potent than morphine.  The gel on the patch controls the release of small amounts of the drug.  The release is very well controlled if used as it was intended – as a patch.  If the patch is tampered with, by smoking, preparation for injecting, or even sucking on it, then the amount of drug that will be released is VERY variable.  That means that one time you may get a little, and another you may get a lot.  That is why the risk of overdosing by abusing Fentanyl is very high.  In fact, I have read or heard about someone dying (none of my patients, thankfully) from overdose of Fentanyl EVERY WEEK for the past few months.  Please keep this in mind, and don’t abuse Fentanyl.

I should make another note about Fentanyl and intravenous use specifically.  Once the gel is cooked, it is a liquid, and this can be injected.  This preparation can return to a gel once it is in your body, and that could result in clogging small arteries.  If those arteries supply blood to your heart, you get a heart attack.  If those arteries supply blood to your brain, you get a stroke.  Think about it.

Over the past few weeks, we have instituted a new policy of randomly testing every patient at the clinic for Fentanyl.  Unfortunately, many people have come up positive.  Soon, we will have new Urine Drug Testing panels that include Fentanyl in every test.

If you currently have carries, please note that those who are found positive for Fentanyl will lose carries, and they will then have to regain the lost carries by being clean of street drugs for 4 weeks, not the usual 1 week.  The reason for this is that the assumption will be that you earned those carries while using Fentanyl, and that you weren’t really clean of opiates while gaining carries.  Again, please think about this.  It makes sense.


So, if you don’t use Fentanyl, then there is no problem.  If you do use it, stop now.  Hopefully it will clear your system before your random, and later your regular, Urine Drug Test for Fentanyl comes up.

Remember, this is all for your benefit.  I am concerned about your health and recovery from opiate addiction.

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Discontinuing Methadone While Still Occasionally using Cocaine

I have a number of patients who are still using cocaine, but are otherwise doing very well in the methadone program. Many of them do not consider the cocaine use to be of any concern, because they ‘only use it once a week,’ or ‘once in a while.’ Even though you may feel that occasional use of cocaine is not a concern, it can be, for reasons I will discuss.

There have been studies done in this area. It seems that people who have conquered their opiate (heroin, OxyContin, etc) addiction, who discontinue methadone while still using cocaine, tend to relapse back onto opiates 80% of the time within the first eight months (reference pending).

This is quite a high relapse rate. Most of the people I have spoken to about this issue have stated that ‘this won’t happen to me.’ Although some of these patients will be correct, 80% will not.

I’m not sure why this relapse onto opiates occurs. The study does not address this. It is possible that if someone is still using cocaine it means that the person is still associating with people using hard drugs. This association in itself is a risk factor for relapse.

Another possibility it that people who still use cocaine occasionally may at some point be presented with an alternative that is not cocaine. They may feel, at the time, that ‘just once’ would be safe. This can then lead to kindling of a prior addiction, and can result in full-blown relapse.

If you fall into this category, and have conquered your opiate addiction, then congratulations. That is fantastic. If you are still using cocaine or crack, and feel that this is not a problem for you, please re-examine your point of view. If you relapse, think of all the hard work that you’ve already done that you will have to do again.

That being said, if you do relapse, don’t wait too long before coming back to the methadone program. You should come in the day after you used, before it turns into a full-blown relapse. Better yet, come in if your are just thinking of using. If you come in early enough, you may not need to go back onto methadone. Simply attending the clinic, and talking with your doctor, can prevent a full-blown relapse.



I have come across some information that may explain what I am saying above.

Some people have said that when they use cocaine, they get anxious or jittery.  They use some sort of opiate (like a perc) to get rid of this.  Some people even say that is how they started with opiates and then ended up on the methadone program.  It seems, on methadone, they do not need the extra opiate, since the methadone “does the job.”  So, it makes sense that if you stop methadone but continue to use cocaine, the jitters will return, and the temptation will be to use an opiate to get rid of it.  Then it is only a matter of time before you get back onto methadone again.  Does this make sense to you?

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Seeing your Therapist as an Ally

Your therapist is trying to help you. This therapist may be your methadone doctor, psychiatrist, family doctor, counselor, psychotherapist,etc. In any case, they are trying to help you. In order to help you, they need all the information that you can give them. If you hold back some information, they may be missing some very important things that could affect your care. It is to your benefit to have full disclosure with your therapist.

In my methadone practice, the biggest area of dishonesty is cheating on urine drug screens (UDS). If you used street drugs, and are worried about losing carries, be reassured that you only lose one carry, and get it back the following week if your UDS is clean. However, if you get caught cheating, you lose all your carries, and cannot get a new carry for one full month. If you cheat a second time, then you lose all carries and cannot get a new carry for three months. This would also seriously erode the trust between you and your doctor. It takes a long time to regain this trust.

It is much better just to be honest, lose the carry for one week, and move on. If you think about it, cheating on your UDS can seriously compromise your recovery.

Being honest about what drugs you are using has other benefits. Addiction is all about dishonesty to yourself. “I can use once and it will be okay,” “I didn’t use that much,” “it isn’t a problem.” These are things that people tell themselves. Even though you may not fully believe it, telling yourself these things downplays the seriousness of your condition. If you lie to your therapist, you can more easily lie to yourself. In order to fully recover, you need to stop lying to yourself most importantly. Not lying to your therapist will help you in not lying to yourself.

Another benefit of honesty is showing your therapist how serious you are in getting better. I have seen many patients come in and tell me “my UDS screen is faulty because it is showing that I did not use, but I did.” They know full well that they will lose a carry by telling me this, even though the UDS is negative. When I mention this, the reply I get is “I know, but I really want to get better.” This speaks volumes. The reason you lose a carry for using drugs is so that you associate a negative consequence with using street drugs. It is for your benefit alone. It is very important that you understand this.

Some people see the therapist as an adversary. They want to “get one over on them.” They may figure that if they can get past the therapist, then they are doing well. They may be embarrassed about using, and don’t want to disappoint therapist. They may think that the therapist will get angry if they tell them that they used recently. Your therapist is not the police. Your therapist is not a parent. Your therapist is not your friend. Your therapist is a professional who is trying to help you in the best way they can with the information that you give them. If you see your therapist as an adversary, then in all likelihood they will not be able to help you.

Your therapist is your ally. Be honest, tell them all the street drugs that you use – even if they don’t ask you – and don’t hold back. Only then can your therapist fully help you. That is the goal, your therapist wants to help you.

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Quitting Smoking

It’s the new year, and many people make resolutions this time year. A very popular resolution is to quit smoking. Although studies have shown that relapse rates for smoking are higher than any other drug, the following can help you with trying to quit.  The good news is that the physical addiction to nicotine only lasts for about three days. After that it’s all psychological, and mostly habit.

The first step is deciding that you want to cut down, or even stop, smoking. Then choose a date for when you want to quit, but make it one or two months in the future. Don’t try to quit tomorrow or the next day. Many people find quitting on a Monday works best. Tell everybody you know that you are going to quit on your quitting day. Ask them not to offer you a cigarette after that day.

Take a week and write down every time you have a cigarette. Write down the reason why you are having a cigarette. It may be because it’s first thing in the morning, after a meal, with a coffee, you’re stressed, you’re happy, you’re driving, and so on.  Theses are your triggers.  Things that make you want to smoke.

Once you have a list of your triggers, order them in priority. Put the ones that are less common at the top and the ones that are more common at the bottom. This is the order you will be addressing your triggers.

Now try to come up with an alternative to smoking cigarettes for each of these triggers. For example, first thing in the morning, instead of having a cigarette try doing a few push-ups or situps. By the end of the exercise, you will likely not want to have a cigarette. For smoking in the car or house, make a deal with yourself that you have to go outside to smoke. If you’re on the highway, you have to pull over and get out of the car to have a cigarette. This will help keep your car and house from smelling like cigarettes, and will reduce the trigger of cigarette smell making you want to have a cigarette. After a while, you will start to dislike the smell of cigarettes.

One thing to watch out for is to not replace one habit with another that is bad for you. For example, replacing smoking when you’re stressed with eating chocolates can results in other problems. Try something you like to do, but that is good for you.

Once you have done the above, you are more than likely to be one or two weeks into the quitting process. Now start by trying to eliminate the trigger at the top of the list. Once you have done that, move to the next one. By the time you get to your quitting day, you will likely be down to the last two or three triggers. These will probably be the hardest triggers to remove, but you will have had experience in removing the other triggers.

After quitting day, try to avoid people who are smoking, places where there is smoke, and things that make you think of smoking. Do this for at least a month.

If this doesn’t seem to work, talk to your doctor about some medication that can help you with the cravings. Most people do not need any such medications, but they come in handy for some people.

Good luck in your endeavour to improve your health and enjoyment of life. Things really do smell, taste, and look better once you quit smoking.

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Depression, Anxiety, and Panic Attacks

Anxiety, Depression, and Panic Attacks are common complaints of people who use street drugs. Sometimes, these problems are actually a result of street drug use. Withdrawal from opioids can cause severe anxiety and depression. Being high on cocaine can cause anxiety. Coming down off of cocaine can cause depression. Prolonged use of marijuana can cause mild chronic anxiety or depression. And so on. You can only tell for sure several weeks after you stop using any street drugs at all.

If it has been several weeks since you last used any street drugs, and you still have some residual anxiety or depression, there may be something else going on. The causes of these symptoms can be many. You may now be seeing the damage the drugs have caused to your life. You may think that repairing this damage is overwhelming. This damage may be in the form of injured relationships, body parts, jobs, or any number of other things that are now important to you that were not important to you while you were using drugs. The good news is that it’s most of these things can in fact be repaired. Have hope, and ask for help. It is hard to do it alone.

On the other hand, some people may have been using drugs to self medicate their anxiety and depression. If this is the case, then when the street drug addiction is treated, they are left with their underlying mental health issues that have not yet been addressed by a professional. Although the best way to treat this is to see a professional counselor, it is often difficult to find one that is for free. Ask your doctor about this, and hopefully they can help you find one, or they may able to treat you themselves.

If you would like to try to treat your anxiety, depression, or panic attacks on your own, look around on this website. On the links section, there are several links to online courses that may be able to help you. They are free. Although these online courses are not optimal treatment, they can be a great substitute if you have no alternative. Talk to your doctor about what you are learning online, and hopefully they can help you fill in the details.

Panic attacks, as opposed to anxiety, is a sudden rush of anxiety and other feelings that lead to a “feeling of impending doom.” Commonly, people have problems breathing and focusing their attention, as well as many other symptoms such as chest pain, sweating, and many many more things. If you experience any of these symptoms, please consult the doctor first. The most important thing is to rule out something that is physically wrong. These symptoms are very similar to heart attacks and other very severe medical conditions. Once these medical conditions have been ruled out, then you are left with the diagnosis of panic attacks. At this point, you can move on to treating them through the techniques noted below.

Often the full-blown panic attack is a result of just worrying about having a panic attack itself. When you feel a panic attack starting, you may start thinking “oh my God I’m going to have a panic attack”. You may then think about this over and over again, concentrating on the physical feelings that you are experiencing. Obviously, this will make a panic attack much worse. The best way to deal with this, is to try to keep your mind off of the panic attack and “talk yourself out of it.” Some counselors call this “riding the wave.” The idea is not to fight the panic feelings, but to accept them, let them flow through you, and concentrate on something else while you wait for the feelings to leave. Many of my patients have tried these techniques, and find that their panic attacks last 30 seconds to one minute if they use these techniques.

The basic idea, is to try to distract your attention from the panic attack onto something else. Choose ONE technique from each of the 2 categories, and work on them. If they don’t seem to be working, try another. Make sure you try it at least once a day. Give it some time, maybe a week. Don’t try too many at once, just one at a time.

1) Distraction Techniques

Exercise – Pushups, Walk, Hike, Bike

Talk to friends
Take photographs
Write a Journal, Poems, Story (some of the best creativity comes from artists at time of great emotional pain)
Play a musical instrument
Play video games
Paint your nails

Cry (this is very good at releasing internal chemicals that will make you feel better)
Draw faces or names on balloons and pop them (for anger)
Throw rolled up socks, pillows, or foam balls against the wall
Scream into a pillow or a secluded place
Punching a pillow

1) Self Soothing Techniques

The second technique is to soothe yourself by using your five senses: sight, touch, smell, hearing, and taste. To find a technique that is good for you, just think about these five senses, and come up with something that you enjoy. The list below is simply a list of examples that you may find helpful.

Carry around a small bottle of perfume or other smell that you enjoy – smell it when you’re feeling bad or about to enter panic attack

A piece of fabric, leather, fur, or even an ice cube that you can rub your hand on and concentrate on the feeling

Eat – chocolate, salty foods, or whatever you find comforting (but watch your weight)
Watch TV movie
Listen to music
Singing a song you like
Have sex with someone you care about
Take a bath

Concentrate on your surroundings:
How many different sounds can you hear? How many birds?
How many different smells can you notice?
Look at the sky and/or your enviroment around you and see how many shapes, textures, and colors you can identify

I hope you find these helpful. Please keep in mind that this is just the beginning. A counselor can help you identify what will help you specifically. They also may have other ideas that can help your case in particular. Good luck, and remember the idea is to enjoy yourself.

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Trouble Sleeping?

Many people have problems with sleeping. And many more people have sleeping issues when they are coming off of street drugs. The good news is that there are many things you can do to help this situation.

If you are having trouble with sleep, the first question you must ask yourself is ‘am I taking any stimulants?’ Stimulants include caffeine (in coffee, tea, Red Bull, and many other things like Tylenol 1), diet pills, some cough and cold remedies, cocaine, amphetamines, ecstasy, LSD, and many more. Stimulants can keep you from getting to sleep. Try cutting those out. Your sleep would likely improve within a few days.

When you are using opiates, benzos, alcohol, or other sedating drugs, sleep is easy. Just take a dose. The problem is that your body gets used to the dose after a while, and you need more to do the same job. The other problem is that if you take too much, the sleep can become permanent – you can die. After a while of going to sleep with the help of drugs, you may start to forget your prior techniques to going to sleep. You may forget that going to sleep is a process that you worked on since you were a little child. When people stop using drugs, they often need to relearn how to go to sleep.

If your mind is active, it is harder to sleep. That is why, for most people, activities like watching TV, playing video games, or just being on the computer right before sleep can keep you from sleeping. Try something more relaxing for you, like reading a book. If you find the book boring, even better. You would likely drift off quite quickly. Give yourself a good 20 minutes of reading before you give up.

Exercising right before sleep can also keep you awake. The increased blood flow and adrenaline will keep you up for some time. On the other hand, being physically tired can help you get to sleep. It can help soothe any anxiety you may be having. So, exercising an hour or more before sleep is actually best.

You can have trouble with sleep when your mind runs around in circles, thinking of things you have to do or that are bothering you. In this case, meditation or relaxation techniques can help greatly. Try some of the MP3s that are on this website on the right hand column. They are instructions, not just music or sounds, that can help you relax and focus your mind on becoming calm and clear. Other websites have these types of instructions as well, so search around. If you don’t like one, just move on to another until you find the one you like.

If you have honestly tried all these things, and are still having difficulty, please talk to your doctor. They can prescribe medications that are safe for you. You may need to do some lab work before starting the medication, as some medications can cause trouble with your liver or other organs. Do not just go to your dealer or friend and ask for drugs. They can be quite dangerous, especially if you are also taking Methadone. Many sedating drugs (i.e., drugs that make you tired) suppress the breathing centre in the brain. So does Methadone. If you add them together, you can stop breathing in your sleep, and die. In fact, the most common way for people to die on Methadone is from also taking alcohol and/or benzodiazepines (such as Valium, Lorazepam, Clonazepam, Ativan, etc).

Your sleep can return to normal. Please try to avoid any medications at all. All medications have side effects and potential complications. Exercise, meditation, relaxing, and clean living do not have any negative side effects or complications.

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